For decades, fiduciary litigation under the Employee Retirement Income Security Act of 1974 (ERISA) was largely concentrated on 401(k) and pension plans. That era has ended. In recent years, we have seen class-action lawsuits...more
2/25/2026
/ 401k ,
Benefit Plan Sponsors ,
Compliance ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
ERISA Litigation ,
Fees ,
Fiduciary Duty ,
Health and Welfare Plans ,
Pharmacy Benefit Manager (PBM) ,
Plan Administrators ,
Regulatory Oversight ,
Third-Party Service Provider
The Consolidated Appropriations Act of 2026 (CAA 2026), signed into law on February 3, 2026, includes provisions that reform how group health plans contract with pharmacy benefit managers (PBMs). The legislation is designed...more
2/25/2026
/ Benefit Plan Sponsors ,
Consolidated Appropriations Act (CAA) ,
Drug Pricing ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Fiduciary Duty ,
Health Insurance ,
New Legislation ,
Pharmacy Benefit Manager (PBM) ,
Regulatory Oversight ,
Reporting Requirements ,
Transparency
The US administration announced the “Great Healthcare Plan” on January 15, 2026, outlining a framework for potential healthcare reform focused on cost containment, consumer choice, and transparency. The proposal builds on...more
1/29/2026
/ Benefit Plan Sponsors ,
Disclosure Requirements ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare Reform ,
Pharmaceutical Industry ,
Prescription Drugs ,
Proposed Legislation ,
Regulatory Agenda ,
Transparency
The US Department of Labor’s Employee Benefits Security Administration (EBSA) has announced updated enforcement priorities for fiscal year 2026. These changes signal where EBSA will focus its investigative and enforcement...more
1/21/2026
/ Benefit Plan Sponsors ,
Corporate Counsel ,
Cybersecurity ,
Data Privacy ,
Department of Labor (DOL) ,
EBSA ,
Employee Benefits ,
Employee Contributions ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Enforcement Priorities ,
Mental Health Parity Rule ,
MEWAs ,
No Surprises Act (NSA)
Alternative prescription drug access models—including direct-to-employer (DTE) and direct-to-consumer (DTC)—are gaining traction as employers reassess traditional pharmacy benefit manager (PBM)-based pricing structures. As...more
1/13/2026
/ Benefit Plan Sponsors ,
Contract Terms ,
Direct to Consumer Sales ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Regulatory Oversight ,
Transparency
Glucagon-like peptide-1 receptor agonists (GLP-1s) such as Ozempic, Wegovy, Mounjaro, and Zepbound have reshaped the landscape of diabetes and obesity treatment and quickly become one of the most significant cost drivers for...more
1/8/2026
/ Americans with Disabilities Act (ADA) ,
Employee Benefits ,
Employees ,
Employer Group Health Plans ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Obesity ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Self-Insured Health Plans ,
Weight-Loss Products
In Williams v. Bally Management Group, LLC, the US District Court for the District of Rhode Island became the first court to grant a motion to dismiss in a class action challenging Bally Management Group’s (Bally) tobacco...more
Annual benefits enrollment, which for many companies will be in the coming months, typically lasts one to two weeks, but the preparation process begins several months in advance. For human resources (HR) and benefits teams,...more
8/29/2025
/ Benefit Plan Sponsors ,
Best Management Practices ,
Compensation & Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employee Training ,
Employer Responsibilities ,
Enrollment ,
Health Savings Accounts ,
Healthcare ,
HSA ,
Human Resources Professionals ,
Plan Administrators ,
Regulatory Requirements
President Donald Trump signed the One Big Beautiful Bill (OBBB) into law on July 4, 2025. The OBBB is a wide-ranging piece of legislation that introduces significant reforms across multiple areas of federal policy, including...more
The US District Court for the Northern District of Texas on June 18, 2025 vacated portions of the HIPAA Privacy Rule to Support Reproductive Health Care Privacy (2024 Final Rule) related to reproductive healthcare privacy....more
The US Department of Health and Human Services (HHS) has rescinded several pieces of informal guidance, including its 2021 interpretation of Section 1557 of the Affordable Care Act (Section 1557), in response to executive...more
President Donald Trump issued an executive order (EO) on May 12, 2025 to address the high cost of prescription drugs in the United States with the goal of ensuring Americans have access to most-favored-nation (MFN) pricing,...more
The US Departments of Labor, Health and Human Services, and the Treasury (the Departments) announced their non-enforcement policy on May 15, 2025, indicating they will not enforce any new requirements imposed by the...more
5/16/2025
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Enforcement Actions ,
Final Rules ,
Health Insurance ,
Mental Health ,
MHPAEA ,
Regulatory Requirements ,
U.S. Treasury
The US Departments of Health and Human Services, Labor, and the Treasury (together, the Departments) filed a motion to suspend the litigation proceedings in The ERISA Industry Committee vs. HHS et al. on May 9, 2025 while the...more
Since taking office, President Donald Trump has issued several executive orders (EOs) and actions that may have an impact on group health plans. These EOs provide insight into the US administration’s policies and outline...more
A growing number of class action lawsuits have been filed against employer-sponsored self-insured group health plans alleging that tobacco cessation wellness programs violate key provisions of the Employee Retirement Income...more
The US Department of Health and Human Services (HHS) on January 6, 2025 issued a notice of proposed rulemaking (NPRM) seeking feedback on proposed updates to the Security Standards for the Protection of Electronic Protected...more
On December 23, 2024, President Biden signed into law two bills that will simplify employer reporting compliance under the Affordable Care Act (ACA). The new laws streamline the rules for employers furnishing ACA reporting...more
The use of artificial intelligence (AI) in the administration of group health plans is nothing new: AI has been used for a number of years to analyze data, improve risk assessment, identify fraud, and streamline claims...more
The US Department of Health and Human Services’ (HHS) final rule on reproductive healthcare privacy is already subject to challenge even before its effective date. As described in our previous blog post, the HHS issued final...more
The Inflation Reduction Act (IRA) made several changes to Medicare Part D that may impact whether employer-sponsored coverage will be creditable for the 2025 plan year. With open enrollment season about to begin, plan...more
The US Departments of Health and Human Services, Labor, and the Treasury (collectively, the Departments) released their much anticipated final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and...more
The US Department of Labor (DOL) issued a press release on September 6, 2024 reminding ERISA plan fiduciaries that it considers cybersecurity to be an area of “great concern” and emphasizing that it continues to investigate...more
The US Department of Health and Human Services (HHS) recently issued final regulations implementing Section 1557 of the Patient Protection and Affordable Care Act, which will restore and expand the scope of civil rights...more
The US Department of Health and Human Services, Office for Civil Rights (OCR) published its Final Rule titled HIPAA Privacy Rule to Support Reproductive Health Care Privacy in the Federal Register on April 26, 2024....more